Vasopressin is a peptide hormone secreted by the posterior pituitary gland. It acts on the kidney to increase water retention and so reduce urine output. For this reason, vasopressin is alternatively known as “antidiuretic hormone”. It also acts on the vasculature, where it produces a hypertensive effect. The cellular receptors that mediate these two actions have been characterised and shown to be different. The antidiuretic action is mediated by the type-2 vasopressin receptor, commonly called the V2 receptor. Agents that can interact with the V2 receptor and activate it in the same way as vasopressin are called V2 receptor agonists (or simply V2 agonists). Such agents will have an antidiuretic action. If these agents interact selectively with the V2 receptor and not the other vasopressin receptor subtypes, then they will not have the hypertensive effect of vasopressin. This would be an important safety consideration and make such agents attractive for the treatment of human disease conditions characterised by polyuria (which is herein taken to mean excessive urine production).

In fact, such an agent is already in use in human therapy. Desmopressin (otherwise [1-desamino, D-Arg8]vasopressin, Minirin™, DDAVP™, Octostim™) is a peptide analogue of vasopressin which is selectively an agonist at the V2 receptor. It is used in the treatment of central diabetes insipidus, which is a condition that results from defective secretion of vasopressin. It is also employed in the control of nocturnal enuresis and may also be of use in the control of nocturia. However, desmopressin is not an ideal agent in all respects. Even the best current syntheses of the agent are lengthy, and desmopressin is not amenable to the most convenient of purification techniques such as crystallisation. Consequently, desmopressin is relatively expensive. It has a very low oral bioavailability, and there is some variability in this parameter.

Overall then, there is a recognised need for a selective vasopressin V2 receptor agonist that is easy to prepare and purify, and that has a high and predictable oral bioavailability. Such properties are most likely to be obtained with a non-peptide compound. Examples of such compounds are disclosed by Ogawa et al. in International Patent Application PCT/JP96/03652 (WO97/22591), by Failli et al. in PCT/US98/15487 (WO99/06403), PCT/US00/00885 (WO00/46224), and PCT/US00/00358 (WO00/46227), by Dusza et al. in PCT/US98/15495 (WO99/06409), and by Steffan and Failli in PCT/US00/00886 (WO00/46225), and PCT/US00/00658 (WO00/46228). However the compounds disclosed in these documents are not ideal drug candidates. For example, some have only moderate selectivity for the V2 receptor and many have only very limited oral bioavailability, probably because they are poorly soluble in aqueous media. The present invention provides compounds that show a better combination of properties.
The anti-diuretic action of desmopressin results in a d crease in the osmolarity of the blood, and this has been shown to be useful in th treatment and prophylaxis of sickle-cell disease. Besides its antidiuretic actions, desmopressin is used to increase the concentration in the blood of the coagulation proteins known as Faktor VIII and von Willebrand factor. In the clinical context, this makes desmopressin useful in the treatment of haemophilia A and von Willebrand's disease. Desmopressin has also been reported to show effects in the central nervous system. For example, it has been reported to be effective in the treatment of Tourette's disease and to be useful in the management of cocaine addiction. Similar applications would be open to the non-peptide agonists of the present invention.